title: Emergency department waiting room: many requests, many insured and many primary care physician referrals.
abstract: BACKGROUND
  Increase in waiting time often results in patients leaving the emergency department (ED) without being seen, ultimately decreasing patient satisfaction. We surveyed low-acuity patients in the ED waiting room to understand their preferences and expectations.
  
  
  METHODS
  An IRB approved, 42-item survey was administered to 400 adult patients waiting in the ED waiting room for >15 min from April to August 2010. Demographics, visit reasons, triage and waiting room facility preferences were collected.
  
  
  RESULTS
  The mean age of patients was 38.9 years (SD = 14.8), and 52.5% were females. About 53.8% of patients were employed, 79.4% had access to a primary care physician (PCP), and 17% did not have any medical insurance. The most common complaint was pain. A total of 44.4% respondents reported that they believed their problems were urgent and required immediate attention, prompting them to come to the ED, while 14.6% reported that they could not get a timely PCP appointment, and 42.9% were actually referred by their PCP to come to the ED. About 57.7% of patients considered leaving the ED if the waiting times were too long. The mean acceptable waiting time before leaving ED was 221 min (SD = 194; median 180 min, IQR 120-270). A total of 39.1% survey respondents reported being most comfortable being triaged by a physician. Respondents were least comfortable being triaged by residents. On analyzing waiting room expectations for the survey respondents, we found that 70% of the subjects wanted a better estimate of waiting time and 43.5% wanted better information on reasons for the long wait.
  
  
  CONCLUSIONS
  Contrary to popular belief, at our ED a large proportion of low-acuity patients has a PCP and is medically insured. Providing patients with appropriate reasons for the wait, an accurate estimate of waiting time and creating separate areas to examine minor illness/injuries would increase patient satisfaction within our population subset.
authors.affiliation: Department of Neurosurgery, University of Rochester Medical Center, 601 Elmwood Ave, Box 670, Rochester, NY 14642, USA. minal_jain@urmc.rochester.edu.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Kamali
authors.forename: Minal
authors.initials: M
authors.lastname: Jain
authors.forename: Anunaya R
authors.initials: AR
authors.lastname: Jain
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Schneider